IORT is typically a component in the multidisciplinary treatment of locally advanced and recurrent cancer, in combination with external beam radiation, surgery, and chemotherapy.
IORT was found to be useful and feasible in the multidisciplinary management of many solid tumors but further studies are needed to determine the benefit more precisely.
[4] The 2015 update of guidelines of the Association of Gynecological Oncology (AGO), an autonomous community of the German Society of Gynecology and Obstetrics (DGGG) and the German Cancer Society includes TARGIT IORT during lumpectomy as a recommended option for women with a T1, Grade 1 or 2, ER positive breast cancer.
These potentially harmful effects can be avoided by delivering the radiation more precisely to the targeted tissues leading to immediate sterilization of residual tumor cells.
[9][10] Electron IORT has the advantages of being able to carefully control the depth of radiation penetration while providing a very uniform dose to the tumor bed.
A few hospitals built shielded operation rooms in which a conventional linear accelerator was installed to deliver the IORT radiation.
This approach was less costly than building a shielded OR for an electron IORT unit and eliminated the logistics involved with patient transportation.
[12] This technique was developed in the late 1980s in an attempt to combine the dosimetric advantages of high-dose rate brachytherapy with the challenges of treating some complex anatomic surfaces with IORT.
Evaluation of the long-term outcomes in patients who were treated with TARGIT-IORT for breast cancer confirmed that it is as effective as whole breast external beam radiotherapy in controlling cancer, and also reduces deaths from other causes[16] as shown in a large international randomised clinical trial published in the British Medical Journal.